吲达帕胺、氯沙坦钾氢氯噻嗪片分别联合硝苯地平控释片治疗老年顽固性单纯收缩期高血压患者的效果及对肾功能指标影响的对照分析

The comparison of the effects and renal function of indapamide and losartan potassium hydrochlorothiazide tablets combined with nifedipine on the treatment of refractory simple systolic hypertension in elderly patients

目的观察吲达帕胺、氯沙坦钾氢氯噻嗪片分别联合硝苯地平控释片治疗老年顽固性单纯收缩期高血压患者的效果及对肾功能指标的影响。方法选取老年顽固性单纯收缩期高血压患者100例,按照随机数表法分为研究组和对照组,研究组给予氯沙坦钾氢氯噻嗪片联合硝苯地平控释片治疗,对照组给予吲达帕胺联合硝苯地平控释片治疗。观察对比2组治疗前后随测血压、24h动态血压及心率、肾功能指标,以及2组的临床疗效。结果2组治疗前及治疗后1,2,4个月随测血压在组间、时点间、组间·时点间交互作用差异均有统计学意义(P<0.05);治疗后,研究组24h平均收缩压(24-hour mean systolic blood pressure,24hSBP)、24h平均舒张压(24-hour mean diastolic blood pressure,24hDBP)、白昼平均收缩压(daytime mean systolic blood pressure,dSBP)、夜间平均收缩压(nighttime mean systolic blood pressure,nSBP)明显优于对照组(P<0.05),而2组舒张压与心率差异均无统计学意义(P>0.05);治疗后,研究组肾功能指标明显优于对照组(P<0.05),2组总有效率差异有统计学意义(P<0.05)。结论氯沙坦钾氢氯噻嗪片联合硝苯地平控释片治疗老年顽固性单纯收缩期高血压效果较吲达帕胺联合硝苯地平控释片方案明显,患者的肾功能改善明显。

Objective To compare the effects and renal function of indapamide and losartan potassium hydrochlorothiazide tablets combined with nifedipine on the treatment of refractory simple systolic hypertension in elderly patients.Methods A total of100patients with refractory simple systolic hypertension were enrolled.They were divided into study group and control group according to the random number table.The study group were given losartan potassium hydrochlorothiazide tablets combined with nifedipine controlled release tablets,the control group were given indapamide combined with nifedipine controlled release tablets treatment.The blood pressure,24h ambulatory blood pressure and heart rate,renal function,and the clinical efficacy of the two groups of patients were measured and observed before and after treatment.Results There were significant differences in the blood pressure between two groups,time points and two-way interaction at1,2and4months after treatment(P<0.05).After treatment,the 24-hour mean systolic blood pressure(24hSBP),24-hour mean diastolic blood pressure(24hdSBP),daytime mean systolic blood pressure(dSBP),nighttime mean systolic blood pressure(nSBP)of the study group were significantly higher than those in the control group(P<0.05).There was not significant difference in diastolic blood pressure and heart rate between two groups(P>0.05).After treatment,the patients in the study group were significantly higher than those in the control group(P<0.05).Conclusion Losartan potassium hydrochlorothiazide tablets combined with nifedipine controlled release tablets to improve the elderly patients with intractable systolic hypertension than indapamide combined with nifedipine sustained-release tablets program is effective,the patients′renal function are improved significantly.